Organizers and Facilitators: Stephanie Mueller, Sarah Apgar, Neil Sehgal, Kirsten Kangelaris, Jeff Schnipper, Andy Auerbach

Background

The Hospital Medicine Reengineering Network (HOMERuN) is a national collaborative bringing together hospital medicine groups from diverse practice settings to advance research, innovation, and shared learning. As the network continues to grow, members have expressed a need for greater clarity around what it means to be a "member," how participation is defined, and how engagement connects to leadership opportunities and academic advancement.



This summary synthesizes insights from recent HOMERuN collaborative discussions focused on membership structure, active participation, and the value of being part of HOMERuN. The goal is to strengthen engagement while preserving the collaborative's inclusive and collaborative nature.

Defining HOMERuN Membership

Across discussion groups, there was broad agreement that defining membership is important but that expectations must remain flexible, respectful of competing demands, and non-punitive.

Key Themes:

• Membership as belonging: Being called a "member" itself was viewed as meaningful and may encourage engagement, even when participation fluctuates over time.
• Active vs. general membership: Participants emphasized the value of distinguishing between general membership (e.g., listserv participation, attending occasional calls) and active membership (e.g., committee work, research participation).
• Participation is episodic: Engagement naturally fluctuates based on clinical, personal, and academic demands. Members favored acknowledging this reality rather than "policing" involvement.
• Low-bar entry points: Several participants noted the importance of allowing individuals to observe or "listen in" for a period of time before committing more deeply, particularly to reduce intimidation for newer or smaller programs.

"For me, HOMERuN is a way to connect with colleagues from across the country who are tackling similar challenges. It’s a great space to find mentors and exchange ideas that I can bring back to my institution."

Proposed Active Membership Criteria

Active members meet at least 2 of the following 4 criteria:

• Attendance at a minimum of 50% of collaborative meetings
• Participation in committee or subcommittee work (as verified by committee leadership)
• Participation in funded HOMERuN research studies (e.g., PI, co-investigator, site lead)
• Participation in other collaborative activities, at the discretion of the Steering Committee

Participants asked for clearer descriptions of committee roles and expectations, in particular more specifics regarding how to "get involved."

Tracking Participation: Keep It Simple

There was strong consensus against intrusive or high-burden tracking systems. Suggested low-resource approaches included:

• Zoom attendance reports or automated tools (e.g., Copilot)
• Chat-based or QR code–based participation markers during meetings
• Optional nominal annual membership fees as a symbolic indicator of commitment

Overall, members favored low resource accountability that relays expectations without creating barriers to participation.

"I think the criteria for active membership is broad enough but ensures active participation. It’s really important to allow people to engage in ways that fit their availability while keeping the tent wide."

Executive Committee Eligibility and Leadership Pathways

Participants broadly supported the proposed eligibility criteria for Executive Committee service, including: (1) Non-trainee; (2) "active membership" as defined above; (3) Engagement in hospital medicine-related activities (patient care, research, etc.); and (4) Evidence of an academic footprint, including but not limited to: track record of extramural funding, track record of peer-reviewed publications/other dissemination activities, clinical leadership experience, and/or track record of mentorship.

Executive Committee members will be voted in by active members of HOMERuN as well as existing Executive Committee and Steering Committee members and PFAC members.

Key Discussion Points:

• Broad definition of "academic footprint: (Criteria #4): Members emphasized that HOMERuN's impact extends beyond grant-funded research to include quality improvement, education, operations, and implementation work.
• Inclusivity across settings: Criteria should ensure that contributors from non-traditional academic environments feel equally eligible.
• Leadership pathways: Formalizing leadership trajectories within HOMERuN was seen as important for sustainability, institutional credibility, and promotion support.

"It's great that the criteria for the executive committee include clinical leadership and mentorship. Not everyone has access to research funding, but they're still making a big impact in hospital medicine."

The Value of HOMERuN Membership

Participants articulated a clear and consistent value in participation as a member of HOMERuN.

What Members Value Most:

• Opportunities to exchange ideas and learn from diverse perspectives
• Access to mentorship, especially for junior faculty and smaller programs
• Research collaboration and multi-site scholarship
• Professional networking that leads to publications, workshops, and lasting professional relationships
• Exposure to innovative care models that can be adapted locally ("see one, do one, teach one")

Barriers to Engagement:

• Competing clinical and administrative demands
• Meeting times that challenge participation across time zones
• Unclear pathways to projects, committees, and leadership roles

Members emphasized that a clearer sense of knowing what projects exist, who leads them, and how to join would significantly lower barriers to engagement.

"HOMERuN helps you build professional relationships that last. Whether it's contributing to publications or just learning from peers, it's a tremendous resource for academic growth."

Opportunities to Enhance Engagement

Several actionable ideas emerged across groups:

• Create well-defined entry points into committees and projects
• Develop structured but flexible opportunities for engagement to accommodate differences in availabilities to participate at different times 
• Clarify expectations around authorship, leadership, and scholarly credit
• More explicitly articulate what HOMERuN “gives back” to members, including recognition and career advancement support

Participants consistently expressed a desire to contribute meaningfully so long as expectations, opportunities for engagement, and incentives are transparent.

"Clearer pathways to involvement — like knowing which committees exist and how to join — would make it easier for people to engage. Transparent expectations for participation and credit would go a long way."

Take-Home Points:



1. There is strong support for defining HOMERuN membership while maintaining flexibility and inclusivity.
2. Active membership criteria are viewed as reasonable as long as participation expectations are clarified and tracking is low-burden.
3. Members value HOMERuN as a community of practice that enables mentorship, collaboration, and scholarship.
4. Making opportunities for engagement, leadership, and recognition more explicit may strengthen participation and sustainability.
5. As HOMERuN evolves, preserving its grassroots, collaborative spirit remains a shared priority.

HOMERuN at SHM Converge 2026!

• Plenary: POINT Study, Steph Mueller (BWH): "Prevalence and Predictors of Potentially Inappropriate Inter-hospital Transfers: Early Results from the POINT Study"
• Oral Presentation: ADEPT Study, Allison Bond (UCSF): "Diagnostic Cross-check: A Multi-institutional Intervention to Facilitate Peer Second Opinion Discussions in Patients Experiencing Clinical Decompensation"
• Oral Presentation - Didactic Breakout: "ADEPT Study and HOMERuN, Partnering for the Right Diagnosis: Engaging Patients to Improve Diagnostic Safety"

ADEPT Study Posters:

• Colorado, Taiju Miyagami: "Informal Peer Diagnostic Second Opinion: Hospitalist Practices and Perspectives"
• Colorado, Angela Keniston: "Understanding Everyday Safety: An Ethnographic Study of Hospitalist Diagnostic Work"
• Mount Sinai, Aveena Kochar: "The Long-Latent Lesion: Unraveling the Mystery of Marjolin Ulcers"
• UCSF, Nathan Ziman: "Training Hospitalists to Conduct Peer-to-Peer Diagnostic Cross-Checks: Early Multicenter Experience from the ADEPT Collaborative Group"
• Wisconsin, Ellen Barbouche: "Local Implementation of a National Diagnostic Cross-Check Intervention to Increase Diagnostic Excellence"

HOMERuN Work Group/Collaborative Posters

• MedEd, Lucy Shi, Finalist: "Exploring Hospitalist Experiences Using Different Rounding Styles"
• MedEd, Lucy Shi: "Early Experience with a Faculty Development Newsletter to Deliver Asynchronous Microteaching"
• Patient Communication, Monish Sheth: "A Multisite Qualitative Assessment of Patient-Provider Communication Practices Across Institutions"
• Substance Use Disorder, Morgan Esperance: Patients on Long-term Opioid Therapy with Acute-on-Chronic Pain: A National Study of Hospitalist Perspectives
• Transitions of Care, Molly Rosenthal: "Heterogeneity and Misaligned Incentives in Discharge Transition Programs: Insights from a Multi-Site Rapid Qualitative Study"
• AWARD (Alcohol Withdrawal Management Study), James Willey: "Evolving Practices in Alcohol Withdrawal Syndrome Management: Insights from Hospitalists Nationwide

Learn more about the POINT Study, the ADEPT Study, and our Work Groups!

New Publication

Investigators from the POINT Study have published a multi-center qualitative study with patients, caregivers, clinicians, and hospital leaders focused on improving Inter-Hospital Transfers (IHTs).

Four overarching problems with IHTs were identified: (1) communicating and engaging patients and families, (2) specialist involvement in IHT decision-making processes, (3) communication and information sharing challenges between hospitals, and (4) capacity management. Improvement strategies to address these problems centered around engaging patients and families consistently in IHT decision-making, increasing the involvement of specialists, and creating standardized approaches to communication, workflows, and handoffs. Study participants proactively identified barriers to improvement strategies, providing hospital system and clinician leaders with new insights to improve IHTs.

Harrison JD, Leykum, LK, Yu A, Kelly C, Mueller SM. From challenges to solutions: A qualitative thematic analysis of inter-hospital transfer processes. G Jen Intern Med. 2025.

Our next HOMERuN meeting will be on May 3, 2026.

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